Disputes over where physicians can practice are becoming more contentious and complex as physicians contract into hybrid arrangements with management services organizations and health systems begin suing one another over physician groups.
Some of these cases are playing out as states narrow the reach of physician noncompetes. Virginia, Utah, Montana and Maine put new limits in place in 2026, and Washington will void all noncompetes June 30, 2027.. In Congress, Democrats introduced the Stop Corporate Takeovers of Physicians Act on Sept. 16, which would restrict physician noncompetes, though most observers expect it to stall.
Here are five physician fights to know:
1. A Schenectady County, N.Y., judge lifted a temporary restraining order that had barred Schenectady-based Ellis Medicine from offering contracts to 27 cardiologists employed by St. Peter’s Health Partners Medical Associates, the Daily Gazette reported Oct. 19. St. Peter’s, part of Albany, N.Y.-based St. Peter’s Health Partners, has filed a notice of appeal. Ellis sued in August, alleging the noncompetes in the cardiologists’ contracts violate an agreement the two systems signed during merger talks that collapsed in June. Two of the cardiologists, Christopher Dibble, MD, and Stephen Piacentine, MD, have filed a counterclaim alleging St. Peter’s enforced the clauses to weaken Ellis’ cardiac program as Ellis explores an affiliation with Albany Med Health System. The New York attorney general’s antitrust bureau has weighed in on the case, and 22 of the 27 cardiologists have given notice and plan to join Ellis in January, according to the Gazette.
“We believe physician retention is achieved by fostering a culture of respect, support and trust, not through litigation,” Ellis CEO Paul Milton said Oct. 9.
2. Boardman, Ohio-based Southwoods Health, a physician-owned hospital, filed suit Oct. 1 alleging noncompete agreements bar two partners at Youngstown (Ohio) Orthopaedic Associates from joining Cleveland Clinic. The orthopedic, pain management and podiatry practice signed a nonbinding letter of intent in June to sell its assets to Cleveland Clinic, and the deal is set to take effect Nov. 1. Southwoods filed the suit in Mahoning County Common Pleas Court.
3. New Brunswick, N.J.-based Saint Peter’s Healthcare System, which is not affiliated with the New York system involved in the Ellis case, sued West Orange, N.J.-based RWJBarnabas Health and former Saint Peter’s board member Maureen Cernadas, MD, on Oct. 14. The complaint alleges Dr. Cernadas negotiated with RWJBarnabas for nearly two years while serving on the Saint Peter’s board without disclosing a conflict. Nine physicians from Brunswick Hills OB/GYN, the practice Dr. Cernadas led, left its owner, Axia Women’s Health, in May to form a joint venture with RWJBarnabas. Patients tied to the group generated about $28 million in net patient revenue for Saint Peter’s in 2025, and the group plans to move deliveries to RWJBarnabas after January 2027, according to the complaint. RWJBarnabas said it has not sought, received or used confidential Saint Peter’s information and called the allegations without merit.
“We believe the actions taken by RWJBH and Dr. Cernadas are improper, unethical and, simply stated, unacceptable,” Saint Peter’s CEO Leslie Hirsch said in an Oct. 14 statement.
4. San Antonio-based South Texas Spinal Clinic sued Brentwood, Tenn.-based Surgery Partners, its San Antonio affiliate and spine surgeon Antonio Webb, MD, on Oct. 9, seeking more than $5 million. The clinic alleges Surgery Partners reviewed its financial records and physician productivity data under a nondisclosure agreement during acquisition talks that ended in December 2025, then used that information to target its highest-revenue physicians. Dr. Webb and three other physicians left in spring 2026 to join South Texas Surgical & Specialty Group, the name under which the Surgery Partners affiliate operates. The suit, filed in the Texas Business Court, alleges trade secret misappropriation, fraud, breach of contract, tortious interference and unfair competition. The defendants had not responded as of Oct. 13.
5. A Minnesota district court judge blocked Aspirus St. Luke’s in Duluth, part of Wausau, Wis.-based Aspirus Health, from enforcing a noncompete against family physician Nyasha Spears, MD, on Feb. 17. The clause would have barred Dr. Spears from offering substantially similar services within 25 miles of her former clinic for two years. She sued in October 2025 to open a direct primary care practice. The judge found that enforcing the noncompete would worsen a documented primary care physician shortage in Minnesota and conflict with the public interest. Aspirus said it is working with the Minnesota attorney general’s office, which is investigating its use of noncompetes, toward a mutually agreeable outcome.
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